Mid-Atlantic Health Law TOPICS

1. In March, the Health Care Access and Cost Commission released its Annual Report on Expenditures and Utilization based on 1996 health care costs. Maryland's health care expenditures increased 3.8% in 1996, compared to a national increase of 4%. Of the total health expenditures, just over 26% were hospital inpatient expenditures compared to 29% inpatient expenditures in 1995. Physicians collected 25% of health care dollars spent in 1996. Radiologists accounted for the highest portions of total payments, followed by cardiology and obstetrics/gynecology. In 1996, 13% of Marylanders were uninsured, while the nation's uninsured rate was 15.6%. About 30% of Marylanders were covered by HMOs, while only 24% of the nation had HMO coverage.

2. In April, the Health Services Cost Review Commission (HSCRC) approved an average inflation rate increase of 1.7% for hospitals. Nevertheless, because of other factors, the HSCRC's expectation and goal is to hold the increase in charge per case to 0%. The HSCRC will perform a "look back" in June and September of 1998, to determine if the average increase in charge per case is meeting the target.

3. In May, the Health Care Access and Cost Commission (HCACC) approved regulations to establish an Institutional Review Board that would review requests for the release of encounter level data from HCACC's medical care data base when the requests ask for patient zip code, practitioner ID and encrypted patient identifiers. The Board will consist of at least five members, each of whom will have expertise in health services research and information security. One of the members must have expertise in ethics. HCACC will review all Board approvals, and researchers must sign an agreement that covers security and confidentiality provisions prior to the data's use.